Immunophilins are cytosolic proteins endowed with peptidylprolyl-cis-trans isomerase (PPIase or rotamase) activity. This family of proteins behave as chaperone molecules causing cis-trans isomerization of specific prolyl amide bonds that could be a rate limiting step in the correct folding of certain proteins. They are also involved in many cellular signal transduction pathways as partners in multiprotein complexes for which binding in the rotamase active site, but not rotamase activity per se, appears to be important (Ruhlmann, et al., Immunobiol., 198, pp. 192-206 (1998)). Immunosuppressive drugs such as FK506, rapamycin and cyclosporin A bind to specific groups of immunophilins. FK506 and rapamycin bind to the so-called FK506-binding proteins (e.g. FKBP-12, -25, -52), whereas the cyclophilins bind to cyclosporin A. It has been shown that binding to the 12kD immunophilin FKBP12 is necessary for FK506 to elicit its immunosuppressive activity. Subsequently, it was also found that FK506 has two binding domains: one that binds to FKBP12 and the other (the effector domain) for the complex of FK506 and FKBP12 that binds to the serine/threonine phosphatase, calcineurin. This complexation inhibits calcineurin and prevents the proliferation of T-lymphocytes, causing immunosuppression. Rapamycin has an effector domain of a different structure, and its complex with FKBP12 binds to a different target protein that, however, has the same effect of inhibiting T-lymphocyte proliferation. For a review, see S. L. Schreiber, et al., Tetrahedron, 48, pp. 2545-2558 (1992).
While FK506 exhibits immunosuppressive effects, analogs lacking the calcineurin binding effector domain are devoid of immunosuppressive activity. Many small molecules that contain the essential elements of the FKBP12 binding domain of FK506 but lack the calcineurin binding domain were found to retain high affinity binding to FKBP12, and behave as rotamase inhibitors (D. S. Yamshita, et al., Bioorg. Med. Chem. Lett., 4, pp. 325-328 (1994); D. M. Armistead, et al., Acta Cryst. D, 51, pp. 522-528 (1995)).
FK506 has been shown to possess neurotrophic properties in vitro and in vivo (W. E. Lyons, et al., Proc. Natl. Acad. Sci USA, 91, pp. 3191-3195 (1994); B. G. Gold, et al., J. Neurosci., 15, pp. 7509-7516 (1995)). However, its immunosuppressive properties as well as other serious side effects are drawbacks to its use as a neuroregenerative agent. Recently, in vitro studies in PC12 cells, SY5Y cells, and chick sensory dorsal root ganglion explant cultures have shown that small molecule, nonimmunosuppressive FKBP12 rotamase inhibitors also promote neurite outgrowth, and a number of these compounds have shown utility in reversal of CNS lesioning and nerve crush in animal models (G. S. Hamilton, et al., Curr. Pharm. Design, 3, pp. 405-428 (1997); B. G. Gold, et al., Exp. Neurol., 147, pp. 269-278 (1997)). Thus, while the calceineurin binding domain of FK506 is necessary for immunosuppressive activity, it is not required for neurotrophic activity.
A 10-50 fold elevated expression of immunophilins in the central nervous system in comparison with the immune system is well documented (S. H. Snyder, et al., Nature Med., 1, pp. 32-37 (1995)). Recently, augmented expression of FKBP12 m-RNA following facial nerve crush and sciatic nerve lesions was established in facial and lumbar motor neurons. The observed augmentation paralleled the enhanced expression of growth associated protein GAP43 mRNA (B. G. Gold, et al., Neurosci. Lett., 241, pp. 25-28 (1998)). These observations make FKBP12 an attractive target for developing nonimmunosuppressive rotamase inhibitors which promote neurite outgrowth. Such compounds are potential therapeutics to reverse neuronal damage caused by neurodegenerative disease or physical trauma.
There have been disclosures of related compounds for overcoming multidrug resistance (MDR) or as immunosuppressants such as: